Healthcare Provider Details

I. General information

NPI: 1962379602
Provider Name (Legal Business Name): RIKIRA SMITH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIRA SMITH FNP

II. Dates (important events)

Enumeration Date: 10/18/2025
Last Update Date: 10/18/2025
Certification Date: 10/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 WATERFIELD DR
GARNER NC
27529-7727
US

IV. Provider business mailing address

1131 PARKTOP DR
CARY NC
27513-2135
US

V. Phone/Fax

Practice location:
  • Phone: 919-634-6208
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number2023086013
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: